Summary

This is a brief report to provide a summary of results from the post-covid-events analyses performed in OpenSAFELY. Cohorts = Pre-Vaccination Outcome = Diabetes (Type-2, Type-1, Unspecified). PLEASE NOTE that these results are preliminary and subject to change.

Cohorts relative to vaccine introduction and variants

Data downloaded as CSV from here N.B.includes B, Alpha, Delta and Omicron variants. Data additionally downloaded from here for pre-September-2020 case estimates before variant monitoring was present.

Cohort selection flow charts

Pre-vaccinated Cohort Flow

Vaccinated Cohort Flow

Unvaccinated Cohort Flow

Table: Patient characteristics of those without COVID history for each cohort and numbers of people who were exposed to COVID-19.

Covariate Covariate Level Prevaccinated Population Prevaccinated N Diagnosed with COVID 19 risk per 100 000 Vaccinated Population Vaccinated N Diagnosed with COVID 19 risk per 100 000 Unvaccinated Population Unvaccinated N Diagnosed with COVID 19 risk per 100 000
All All 15,175,714 (100) 826,582 (5,447) 11,789,177 (100) 749,030 (6,354) 2,859,217 (100) 147,221 (5,149)
sex Female 7,661,354 (50.5) 450,927 (5,886) 6,215,420 (52.7) 422,129 (6,792) 1,175,305 (41.1) 78,623 (6,690)
sex Male 7,514,360 (49.5) 375,655 (4,999) 5,573,757 (47.3) 326,901 (5,865) 1,683,912 (58.9) 68,598 (4,074)
ethnicity White 11,903,511 (78.4) 620,076 (5,209) 9,707,785 (82.3) 638,738 (6,580) 1,779,237 (62.2) 112,236 (6,308)
ethnicity Mixed 172,865 (1.1) 11,633 (6,730) 106,623 (0.9) 6,461 (6,060) 69,993 (2.4) 3,656 (5,223)
ethnicity South Asian 898,418 (5.9) 91,607 (10,196) 602,213 (5.1) 31,935 (5,303) 275,991 (9.7) 9,083 (3,291)
ethnicity Black 310,993 (2) 21,368 (6,871) 172,488 (1.5) 7,751 (4,494) 147,557 (5.2) 7,089 (4,804)
ethnicity Other 324,162 (2.1) 16,366 (5,049) 197,166 (1.7) 9,022 (4,576) 160,219 (5.6) 3,869 (2,415)
ethnicity Missing 1,565,765 (10.3) 65,532 (4,185) 1,002,902 (8.5) 55,123 (5,496) 426,220 (14.9) 11,288 (2,648)
deprivation 1-2 (most deprived) 2,884,715 (19) 199,770 (6,925) 1,855,885 (15.7) 112,614 (6,068) 853,767 (29.9) 44,237 (5,181)
deprivation 3-4 2,979,353 (19.6) 178,027 (5,975) 2,178,752 (18.5) 135,956 (6,240) 686,486 (24) 34,821 (5,072)
deprivation 5-6 3,270,564 (21.6) 165,138 (5,049) 2,608,923 (22.1) 161,359 (6,185) 572,151 (20) 29,274 (5,116)
deprivation 7-8 3,125,930 (20.6) 151,191 (4,837) 2,608,726 (22.1) 168,320 (6,452) 436,022 (15.2) 22,481 (5,156)
deprivation 9-10 (least deprived) 2,915,152 (19.2) 132,456 (4,544) 2,536,891 (21.5) 170,781 (6,732) 310,791 (10.9) 16,408 (5,279)
region East 3,573,633 (23.5) 190,145 (5,321) 2,803,397 (23.8) 161,606 (5,765) 651,907 (22.8) 34,026 (5,219)
region East Midlands 2,660,822 (17.5) 157,083 (5,904) 2,062,410 (17.5) 138,181 (6,700) 469,981 (16.4) 28,224 (6,005)
region London 953,066 (6.3) 52,592 (5,518) 601,019 (5.1) 31,973 (5,320) 402,794 (14.1) 10,645 (2,643)
region North East 745,041 (4.9) 50,517 (6,780) 570,462 (4.8) 43,106 (7,556) 123,655 (4.3) 7,181 (5,807)
region North West 1,351,813 (8.9) 89,454 (6,617) 1,061,351 (9) 75,200 (7,085) 194,470 (6.8) 11,823 (6,080)
region South East 1,012,424 (6.7) 41,114 (4,061) 826,297 (7) 50,120 (6,066) 172,818 (6) 8,829 (5,109)
region South West 2,137,597 (14.1) 63,752 (2,982) 1,838,482 (15.6) 113,835 (6,192) 286,399 (10) 17,461 (6,097)
region West Midlands 576,450 (3.8) 42,844 (7,432) 399,351 (3.4) 24,838 (6,220) 148,932 (5.2) 7,454 (5,005)
region Yorkshire and The Humber 2,164,868 (14.3) 139,081 (6,424) 1,626,408 (13.8) 110,171 (6,774) 408,261 (14.3) 21,578 (5,285)
smoking status Never smoker 7,088,744 (46.7) 422,829 (5,965) 5,619,699 (47.7) 371,342 (6,608) 1,178,313 (41.2) 59,118 (5,017)
smoking status Ever smoker 4,781,706 (31.5) 250,809 (5,245) 4,107,299 (34.8) 280,313 (6,825) 560,552 (19.6) 42,410 (7,566)
smoking status Current smoker 2,650,985 (17.5) 115,959 (4,374) 1,668,733 (14.2) 82,264 (4,930) 785,342 (27.5) 37,154 (4,731)
smoking status Missing 654,279 (4.3) 36,985 (5,653) 393,446 (3.3) 15,111 (3,841) 335,010 (11.7) 8,539 (2,549)
bmi groups Healthy_weight 4,806,928 (31.7) 231,382 (4,814) 3,730,127 (31.6) 229,980 (6,165) 931,142 (32.6) 46,758 (5,022)
bmi groups Underweight 283,648 (1.9) 13,039 (4,597) 203,769 (1.7) 9,397 (4,612) 80,957 (2.8) 3,419 (4,223)
bmi groups Overweight 4,451,907 (29.3) 234,464 (5,267) 3,680,896 (31.2) 239,204 (6,499) 587,603 (20.6) 35,693 (6,074)
bmi groups Obese 3,155,545 (20.8) 199,987 (6,338) 2,675,675 (22.7) 194,995 (7,288) 364,290 (12.7) 28,619 (7,856)
bmi groups Missing 2,477,686 (16.3) 147,710 (5,962) 1,498,710 (12.7) 75,454 (5,035) 895,225 (31.3) 32,732 (3,656)
age group 18-29 2,766,105 (18.2) 216,349 (7,821) 1,572,826 (13.3) 84,052 (5,344) 881,360 (30.8) 40,039 (4,543)
age group 30-39 2,813,879 (18.5) 183,955 (6,537) 1,772,688 (15) 134,877 (7,609) 876,730 (30.7) 51,058 (5,824)
age group 40-49 2,682,572 (17.7) 168,528 (6,282) 1,979,944 (16.8) 214,431 (10,830) 550,325 (19.2) 33,775 (6,137)
age group 50-59 2,755,651 (18.2) 154,407 (5,603) 2,344,031 (19.9) 179,121 (7,642) 321,822 (11.3) 16,044 (4,985)
age group 60-69 1,996,255 (13.2) 66,053 (3,309) 1,867,109 (15.8) 85,034 (4,554) 145,286 (5.1) 4,621 (3,181)
age group 70-79 1,492,285 (9.8) 25,991 (1,742) 1,512,358 (12.8) 39,359 (2,602) 59,091 (2.1) 1,206 (2,041)
age group 80-89 585,198 (3.9) 8,852 (1,513) 627,148 (5.3) 10,279 (1,639) 19,754 (0.7) 405 (2,050)
age group 90+ 83,769 (0.6) 2,447 (2,921) 113,073 (1) 1,877 (1,660) 4,849 (0.2) 73 (1,505)
consulation rate group 0 4,251,535 (28) 188,009 (4,422) 2,926,673 (24.8) 170,113 (5,813) 1,550,844 (54.2) 45,547 (2,937)
consulation rate group 1 to 6 5,957,458 (39.3) 347,783 (5,838) 4,812,285 (40.8) 320,995 (6,670) 804,368 (28.1) 57,319 (7,126)
consulation rate group 6+ 4,966,721 (32.7) 290,790 (5,855) 4,050,219 (34.4) 257,922 (6,368) 504,005 (17.6) 44,355 (8,801)
consulation rate Mean 5 6 6 5 3 5
tc hdl ratio Mean 4 4 4 4 4 4
History of all stroke TRUE 176,279 (1.2) 6,243 (3,542) 184,967 (1.6) 6,463 (3,494) 10,048 (0.4) 548 (5,454)
History of ami TRUE 248,660 (1.6) 8,571 (3,447) 252,988 (2.1) 9,412 (3,720) 12,901 (0.5) 684 (5,302)
History of angina TRUE 384,477 (2.5) 12,426 (3,232) 381,653 (3.2) 13,802 (3,616) 15,388 (0.5) 810 (5,264)
History of cancer TRUE 4,581,503 (30.2) 282,844 (6,174) 4,091,955 (34.7) 321,575 (7,859) 542,092 (19) 50,801 (9,371)
History of carehome status TRUE 25,655 (0.2) 3,972 (15,482) 29,267 (0.2) 1,378 (4,708) 2,000 (0.1) 70 (3,500)
History of chronic kidney disease TRUE 637,649 (4.2) 21,221 (3,328) 654,909 (5.6) 22,271 (3,401) 30,240 (1.1) 1,777 (5,876)
History of chronic obstructive pulmonary disease TRUE 374,624 (2.5) 12,697 (3,389) 368,930 (3.1) 13,582 (3,681) 20,837 (0.7) 1,001 (4,804)
History of dementia TRUE 81,044 (0.5) 5,399 (6,662) 94,867 (0.8) 2,915 (3,073) 3,017 (0.1) 154 (5,104)
History of depression TRUE 4,212,896 (27.8) 239,556 (5,686) 3,494,127 (29.6) 239,874 (6,865) 631,362 (22.1) 47,049 (7,452)
History of diabetes gestational TRUE 82,980 (0.5) 6,448 (7,771) 75,904 (0.6) 8,444 (11,125) 22,478 (0.8) 2,561 (11,393)
History of healthcare worker TRUE 480,633 (3.2) 55,407 (11,528) 414,767 (3.5) 33,701 (8,125) 17,582 (0.6) 2,084 (11,853)
History of hf TRUE 180,577 (1.2) 6,366 (3,525) 204,741 (1.7) 7,166 (3,500) 8,572 (0.3) 476 (5,553)
History of hypertension TRUE 4,358,003 (28.7) 201,059 (4,614) 3,999,711 (33.9) 212,405 (5,311) 372,096 (13) 27,135 (7,292)
History of liver disease TRUE 85,527 (0.6) 3,951 (4,620) 78,270 (0.7) 3,746 (4,786) 12,788 (0.4) 651 (5,091)
History of other arterial embolism TRUE 68,884 (0.5) 2,692 (3,908) 83,968 (0.7) 3,513 (4,184) 4,914 (0.2) 281 (5,718)
History of prediabetes TRUE 731,601 (4.8) 30,118 (4,117) 821,101 (7) 35,836 (4,364) 52,224 (1.8) 3,352 (6,419)
History of vte TRUE 216,641 (1.4) 9,425 (4,351) 214,363 (1.8) 11,133 (5,194) 21,533 (0.8) 1,662 (7,718)

Table: Numbers of events in OpenSAFELY before and after diagnosis of COVID-19.

To be completed.

Figure: Maximally adjusted hazard ratios (log scale) for different diabetes events by time since diagnosis of COVID-19.

N.B. There were too few events for Other or Non-Specific Diabetes in the Unvaccinated Cohort.

Figure: Maximally adjusted hazard ratios (log scale) for Type-2 Diabetes by time since diagnosis of Hospitalised / Non-Hospitalised COVID-19.

Figure: Maximally adjusted hazard ratios (log scale) for Type-2 Diabetes by time since diagnosis of COVID-19 for Age, Sex and Ethnicity Subgroups.

N.B. Results not shown for any subgroup with too few events according to criteria set out in the pre-specified analysis plan

Figure: Maximally adjusted hazard ratios (log scale) for Type-2 Diabetes by time since diagnosis of COVID-19 (full time points).

N.B. Full time point results were not ran in the unvaccinated cohort due to the number of events.

Figure: Maximally adjusted hazard ratios (log scale) for Type-2 Diabetes by time since diagnosis of COVID-19 for Stratified by History of Obesity or Pre-Diabetes.

Diabetes flow charts: showing the assignment of diabetes cases using the diabetes diagnostic algorithm.

All values have been rounded to the nearest multiple of 7 to avoid potential disclosure and back-calculation.

Prevaccinated Cohort.

Vaccinated Cohort.

Unvaccinated Cohort.

Table: Describing the number of Type-2 Diabetes cases diagnosed in each cohort throughout the study period using numbers from the diabetes flow charts.

Measure Prevaccinated Vaccinated Unvaccinated
Duration (days) 535 197 197
Sample Size 15176232 12752330 3095271
Type 2 Diabetes cases during study period (N) 184800 83902 6839
Type 2 Diabetes cases during study period (%) 1.22 0.66 0.22
Averaged number of Type 2 Diabetes diagnoses per day 345 425 35